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慢性踝关节不稳患者的鞋类对步行生物力学的影响。

The influence of footwear on walking biomechanics in individuals with chronic ankle instability.

机构信息

Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, PQ, Canada.

Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, PQ, Canada.

出版信息

PLoS One. 2020 Sep 24;15(9):e0239621. doi: 10.1371/journal.pone.0239621. eCollection 2020.

Abstract

BACKGROUND/PURPOSE: The effects of footwear on the walking kinematics, kinetics and electromyography (EMG) of individuals with chronic ankle instability (CAI) at different speeds are still unknown. The objective of this cross-sectional study was to evaluate the kinematic, kinetic and electromyography differences between shod and barefoot walking at comfortable (CW) and fast (FW) speeds in individuals with CAI.

METHODS

Twenty-one individuals with CAI walked on a 5-meter walkway shod and barefoot at CW and FW speeds. A force plate was used to record the ground reaction forces, a 3-D motion analysis system to record the lower limb kinematics and a surface EMG system to collect the gluteus medius, vastus lateralis, gastrocnemius lateralis, gastrocnemius medialis, peroneus longus and tibialis anterior muscles activity. The dependent variables were ankle and knee angles and moments and normalized muscle activity. The shod and barefoot data during CW and FW were compared using a one-dimensional non-parametric mapping analysis.

RESULTS

The main results of this study were that individuals with CAI exhibited more ankle dorsiflexion angle, knee extension and tibialis anterior muscle activation during the beginning of the stance phase during shod compared to barefoot walking. Also, the biomechanical effects of shoes are similar during walking at FW and CW.

CONCLUSION

The biomechanical deficits associated with CAI were partly attenuated during the shod compared to the barefoot condition and these effects were similar at CW and FW. These findings are compatible with the concept that locomotor interventions using suitable shoes may enhance gait abilities in individuals with CAI.

摘要

背景/目的:目前尚不清楚不同速度下,鞋类对慢性踝关节不稳(CAI)患者行走运动学、动力学和肌电图(EMG)的影响。本横断面研究的目的是评估 CAI 患者舒适(CW)和快速(FW)速度下穿鞋和赤脚行走的运动学、动力学和肌电图差异。

方法

21 名 CAI 患者在 5 米步行道上以 CW 和 FW 速度穿鞋和赤脚行走。力板用于记录地面反作用力,3D 运动分析系统用于记录下肢运动学,表面肌电图系统用于收集臀中肌、股外侧肌、腓肠外侧肌、腓肠内侧肌、腓骨长肌和胫骨前肌的活动。依赖变量为踝关节和膝关节角度和力矩以及归一化肌肉活动。使用一维非参数映射分析比较 CW 和 FW 期间的穿鞋和赤脚数据。

结果

本研究的主要结果是,与赤脚行走相比,CAI 患者在穿鞋时,在支撑相初期表现出更大的踝关节背屈角度、膝关节伸展和胫骨前肌激活。此外,在 FW 和 CW 行走时,鞋子的生物力学效应相似。

结论

与赤脚相比,CAI 患者在穿鞋时部分减轻了与 CAI 相关的生物力学缺陷,并且这些影响在 CW 和 FW 时相似。这些发现与使用合适的鞋子进行运动干预可以增强 CAI 患者的步态能力的概念是一致的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c53/7514089/39bd7657ff15/pone.0239621.g001.jpg

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